Does scaphotrapezotrapezoid osteoarthritis affect trapeziometacarpal prosthesis outcomes?

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Osteoarthritis Research

Background:

• Pantrapezial osteoarthritis (OA), a combination of trapeziometacarpal (TMC) and scaphotrapeziotrapezoid (STT) joint involvement, has historically been viewed as a contraindication for TMC arthroplasty.
• This perception necessitates an evaluation of TMC arthroplasty outcomes in the presence of associated STT OA.

Purpose of the Study:

• To assess the functional and radiological results of TMC prostheses in patients with and without concurrent STT OA.
• To determine if STT OA influences the success of TMC arthroplasty.

Main Methods:

• A retrospective, observational, multicenter study analyzed 113 TMC prostheses (ISIS® or HORUS®) in 94 patients with a mean 6.4-year follow-up.
• Functional outcomes were measured using QuickDASH, Buffalo score, TASD, Kapandji score, and pinch strength tests.
• Radiographic assessments utilized Dell, Crosby, and SCFM classifications.

Main Results:

• No statistically significant differences in functional scores or radiological complications were found between patients with isolated TMC OA and those with pantrapezial OA.
• Radiological progression of STT OA occurred in 20% of cases but did not lead to significant functional impairment.
• Forty prostheses were implanted in patients with pantrapezial OA.

Conclusions:

• Associated STT OA does not appear to compromise clinical outcomes following TMC arthroplasty at mid- to long-term follow-up.
• Surgical decisions for thumb base arthritis should prioritize patient symptoms and expectations over isolated radiographic findings.